Same Care, Lower Cost Act

The "Same Care, Lower Cost Act" proposes significant changes to Medicare Part B by establishing site-neutral payments for certain services furnished in ambulatory settings. Starting in 2027, this legislation directs the Secretary of Health and Human Services to ensure that payment rates for identified services are the same, regardless of whether they are provided in a hospital outpatient department, an ambulatory surgical center, or another appropriate setting. The Secretary is tasked with identifying at least 66 specific Ambulatory Payment Classifications (APCs) that are suitable for site-neutral payments. However, the bill explicitly exempts emergency department, critical care, and trauma care visits from these site-neutral payment provisions, reclassifying them as Comprehensive APCs. In implementing these changes, the Secretary is required to consider recommendations from the Medicare Payment Advisory Commission (MedPAC) regarding payment rate alignment across ambulatory settings.